Jonas Åkerlund's original plan was to use real devotees of suspension - the S&M practice depicted in the film - as the murder victims. However, he soon encountered all sorts of issues with Health & Safety over the spilling of real human blood (an unavoidable consequence of having hooks pierced into skin) so opted for prosthetics instead.
Director Jonas Åkerlund was particularly keen on making the movie as authentic as possible in real locations. Consequently only two sets were built for the film.
Shooting in Winnipeg, Canada, in the middle of winter meant the production frequently encountered temperatures in the region of 40-45 degrees below.
Part of Dennis Quaid's contract was that he was allowed to go back to Los Angeles every weekend. He chose not to exercise that option as he enjoyed himself so much on the shoot, even bringing his wife and his band up to Winnipeg on occasion.
Despite significant reshoots, the running time of the DVD is 20 minutes shorter than the original running time.